Coaches Activating Reaching and Engaging Patients

Stanford Cancer Institute plans to implement and evaluate several critical elements to be in
alignment with the mission of the organization to provide high value care to their patients.
The CAREPLAN (Coaches Activating, Reaching, and Engaging Patients in Their End of Life Care
Plan) intervention is an innovative program aimed to strengthen provider-patient
relationships and facilitate whole person care about matters important to patients diagnosed
with advanced stages of cancer and important to patients' support network and family. The
project is intended to help establish patients' Goals of Care Plan with appropriate
documentation, develop, deploy, and evaluate a model of care for patients with cancer that is
intended to improve clinical outcomes and their experiences with their cancer care. The
intervention provides patients with lay navigators who assist them and their families in
formulating and discussing their goals of care with their health care teams in hopes to
engage in shared-decision making for goal concordant care. The goal of the project is to
demonstrate that there is improved documentation of goals of care, patient experiences,
patient activation, quality of life, and quality of care and communication and that the
program helps to improve goal concordant care receipt at the end of life.

Inclusion Criteria:

- All patients who receive care at Stanford Cancer Institute and have genitourinary
cancers and have received greater than 2 prior courses of chemotherapy treatment

Exclusion Criteria:

- Patients without capacity to consent